Carcinoembryonic antigen as a tumor marker in lung cancer – is it clinically useful?
DOI:
https://doi.org/10.15584/ejcem.2018.1.9Keywords:
carcinoembryonic antigen, lung cancer, prognostic factor, tumor markerAbstract
Introduction. Lung cancer is the most common cancer in the Western world. Annually there are approximately 1.8 million new cases worldwide. It is characterized by poor prognosis with a 5-year survival of 10-17% depending on the country. Contributing to this poor prognosis is a mainly late diagnosis, as well as a fairly frequent recurrence despite radical surgery. Over the years, scientists have been searching for a tumor marker that would be useful for patients with lung cancer.
Aim. The aim of this study is to discuss the significance of carcinoembryonic antigen (CEA) in the diagnosis, prognosis of the disease course, and monitoring patients with lung cancer.
Methods. Review of the literature using the PubMed database, Termedia, Via Medica and the key issue: carcinoembryonic antigen as a tumor marker in lung cancer.
Conclusion. Serum CEA level can be a reliable complement to the diagnosis of lung cancer. It can be helpful in preoperative prediction of disease course and qualification for adjuvant treatment of non-small cell lung cancer especially adenocarcinoma. Trends and normalization of CEA during chemotherapy have an impact on progression-free survival and overall survival (OS) of patients. Various available publications describe CEA as a marker for metastatic lung cancer, which is the most specific for metastasis in the liver and brain.
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References
World Cancer Report 2014 [Internet]. gco.iarc.fr/today/home. Accessed: 26.08.2016.
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.
Krajowy Rejestr Nowotworów [Internet]. http://epid.coi.waw.pl/krn. Accessed: 26.08.2016.
United Kingdom Lung Cancer Coalition [Internet]. http://www.uklcc.org.uk/patient-information/facts-about-lung-cancer. Accessed: 26.08.2016.
Krajowy Rejestr Nowotworów [Internet]. http://onkologia.org.pl/nowotwory-zlosliwe-oplucnej-pluca-c33-34/. Accessed: 26.08.2016.
Krzakowski M, Warzocha K. Zalecenia postępowania diagnostyczno- terapeutycznego w nowotworach złośliwych 2013 rok. Nowotwory płuca i opłucnej oraz osierdzia. Gdańsk: Via Medica; 2013.
Denisso T. Rak płuca - Przewodnik dla chorych. Warszawa: Roche Polska Sp. z o.o.
Boyd JA, Hubbs JL, Kim DW, Hollis D, Marks LB, Kelsey CR. Timing of local and distant failure in resected lung cancer: implications for reported rates of local failure. J Thorac Oncol. 2010;5:211-214.
Carnio S, Novello S, Papotti M, Loiacono M, Scagliotti GV. Prognostic and predictive biomarkers in early stage non-small cell lung cancer: tumor based approaches including gene signatures. Transl Lung Cancer Res. 2013;2(5):372–381.
Bayarri-Lara C, Ortega FG, Cueto Ladron de Guevara A, et al. Circulating tumor cells identify early recurrence in patients with non-small cell lung cancer undergoing radical resection. PLoS ONE. 2016;11:e0148659. 10.1371/journal.pone.0148659
Coello MC, Luketich JD, Litle VR. Prognostic significance of micrometastasis in non-small cell lung cancer. Clin Lung Cancer. 2004;5:214–225.
Będkowska GE, Ławicki S, Szmitkowski M. Markery nowotworowe przydatne w diagnostyce i monitorowaniu raka endometrium i szyjki macicy. Postep Hig Med Dosw. 2007;61:122-128.
Soborczyk A, Deptała A. Markery nowotworowe w praktyce klinicznej. Choroby Serca i Naczyń. 2007;4(4):184–189.
Hammarström S. The carcinoembryonic antigen (CEA) family: structures, suggested functions and expression in normal and malignant tissues. Semin Cancer Biol. 1999;9:67–81.
Johnson PWM, Joel SP, Love S, et al. Tumour markers for prediction of survival and monitoring of remission in small cell lung cancer. Br J Cancer. 1993;67:760–766.
Niho S, Nishiwaki Y, Goto K, et al. Significance of serum pro-gastrin-releasing peptide as a predictor of relapse of small cell lung cancer: comparative evaluation with neuron-specific enolase and carcinoembryonic antigen. Lung Cancer. 2000;27:159–167.
Okamura K, Takayama K, Izumi M, Harada T, Furuyama K, Nakanishi Y. Diagnostic value of CEA and CYFRA 21-1 tumor markers in primary lung cancer. Lung Cancer. 2013;80:45–49.
Ma L, Xie XW, Wang HY, Ma LY, Wen ZG. Clinical Evaluation of Tumor Markers for Diagnosis in Patients with Non-small Cell Lung Cancer in China. Asian Pac J Cancer Prev. 2015;16:4891-4894.
Wang R, Wang G, Zhang N, Li X, Liu X. Clinical Evaluation and Cost-Effectiveness Analysis of Serum Tumor Markers in Lung Cancer. BioMed Research International. 2013; Article ID 195692.
Ghosh I, Bhattacharjee D, Das AK, Chakrabarti G, Dasgupta A, Dey SK. Diagnostic Role of Tumour Markers CEA, CA15-3, CA19-9 and CA125 in Lung Cancer. Indian J Clin Biochem. 2013;28(1):24–29.
Charalabopoulos K, Karakosta A, Bablekos G, et al. CEA levels in serum and BAL in patients suffering from lung cancer: correlation with individuals presenting benign lung lesions and healthy volunteers. Med Oncol. 2007;24(2):219–225.
Dąbrowska M, Grubek-Jaworska H, Domagała-Kulawik J, et al. Diagnostic usefulness of selected tumor markers (CA125, CEA, CYFRA 21-1) in bronchoalveolar lavage fluid in patients with non-small cell lung cancer. Pol Arch Med Wewn. 2004;111(6):652–659.
Pardos MC, Alvarez-Sala R, Terreros Caro FJ, Gomez L, de Gomez Terreros FJ, Villamor J. The concentrations of five tumor markers in both BAL fractions in lung cancer patients in relation to cigarette smoking. Tumori. 1999;85(6):454–457.
Tomita M, Matsuzaki Y, Edagawa M, Shimizu T, Hara M, Onitsuka T. Prognostic significance of preoperative serum carcinoembryonic antigen level in lung adenocarcinoma but not squamous cell carcinoma. Ann Thorac Cardiovasc Surg. 2004;10:76–80.
Matsuoka K, Sumitomo S, Nakashima N, Nakajima D, Misaki N. Prognostic value of carcinoembryonic antigen and CYFRA21-1 in patients with pathological stage I non-small cell lung cancer. Eur J Cardiothorac Surg. 2007;32:435–439.
Buccheri G, Ferrigno D. Identifying patients at risk of early postoperative recurrence of lung cancer: a new use of the old CEA test. Ann Thorac Surg. 2003;75:973–980.
Okada M, Nishio W, Sakamoto T, et al. Prognostic significance of preoperative carcinoembryonic antigen in non-small cell lung cancer: Analysis of 1000 consecutive resections for clinical stage I disease. Ann Thorac Surg. 2004;78:216-221.
Muley T, Dienemann H, Ebert W. CYFRA 21-1 and CEA are independent prognostic factors in 153 operated stage I NSCLC patients. Anticancer Res. 2004;24:1953–1956.
Blankenburg F, Hatz R, Nagel D, et al. Preoperative CYFRA 21–1 and CEA as prognostic factors in patients with stage I non-small cell lung cancer: external validation of a prognostic score. Tumour Biol. 2008;29(4):272–277.
Kulpa J, Wójcik E , Reinfuss M, Kołodziejski L. Carcinoembryonic Antigen, Squamous Cell Carcinoma Antigen, CYFRA 21-1, and Neuron-specific Enolase in Squamous Cell Lung Cancer Patients. Clin Chem. 2002;48(11):1931-1937.
Takamochi K, Nagai K, Suzuki K, Yoshida J, Ohde Y, Nishiwaki Y. Clinical predictors of N2 disease in nonsmall cell lung cancer. Chest. 2000;117(6):1577-1582.
Niho S, Shinkai T. Tumor markers in lung cancer. Gan To Kagaku Ryoho. 2001;289130:2089-2093.
Zhao LD, Li JL, Wang Y, et al. Factors affecting the sensitivity of EGFR-TKI treatment in advanced non-small cell lung cancer. Zhonghua Zhong Liu Za Zhi. 2011;33:217–221.
Jung M, Kim SH, Lee YJ, et al. Prognostic and predictive value of CEA and CYFRA 21-1 levels in advanced non-small cell lung cancer patients treated with gefitinib or erlotinib. Exp Ther Med. 2011;2:685–693.
Romero-Ventosa EY, Blanco-Prieto S, González-Piñeiro AL, et al. Pretreatment levels of the serum biomarkers CEA, CYFRA 21-1, SCC and the soluble EGFR and its ligands EGF, TGF-alpha, HB-EGF in the prediction of outcome in erlotinib treated non-small-cell lung cancer patients. Springerplus. 2015;4:171.
Cui S, Xiong L, Lou Y, et al. Factors that predict progression-free survival in Chinese lung adenocarcinoma patients treated with epidermal growth factor receptor tyrosine kinase inhibitors. J Thorac Dis. 2016;8(1):68–78.
Jin B, Dong Y, Wang H, Huang J, Han B. Correlation between serum CEA levels and EGFR mutations in Chinese nonsmokers with lung adenocarcinoma. Acta Pharmacol Sin. 2014;35(3):373–380.
Kappers I, Vollebergh MA, van Tinteren H, et al. Soluble Epidermal Growth Factor Receptor (sEGFR) and Carcinoembryonic Antigen (CEA) concentration in patients with non-small cell lung cancer: correlation with survival after erlotinib and gefitinib treatment. Ecancermedicalscience. 2010;4:178.
Chen YM, Lai CH, Chang HC, et al. Baseline, Trend, and Normalization of Carcinoembryonic Antigen as Prognostic Factors in Epidermal Growth Factor Receptor-Mutant Nonsmall Cell Lung Cancer Patients Treated With First-Line Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors. Medicine (Baltimore). 2015;94(50):e2239. doi: 10.1097/MD.0000000000002239.
Arrieta O, Villarreal-Garza C, Martinez-Barrera L, et al. Usefulness of serum carcinoembryonic antigen (CEA) in evaluating response to chemotherapy in patients with advanced non small-cell lung cancer: a prospective cohort study. BMC Cancer. 2013;13:254–260.
Czepczyńska-Krężel H, Krop-Wątorek A. Rodzina ludzkich białek antygenu karcynoembrionalnego, struktura i funkcja. Postepy Hig Med Dosw (online). 2012;66:521-533.
Updyke TV, Nicolson GL. Malignant melanoma cell lines selected in vitro for increased homotypic adhesion properties have increased experimental metastatic potential. Clin Exp Metastasis. 1986;4:273–284.
Tooth, CA, Thomas P, Broitman SA, Zamcheck N. A new Kupffer cell receptor mediating plasma clearance of carcinoembryonic antigen by the rat. Biochem J. 1982;15;204(2):377-381.
Beauchemin N, Arabzadeh A. Carcinoembryonic antigen-related cell adhesion molecules (CEACAMs) in cancer progression and metastasis. Cancer Metastasis Rev. 2013;32(3-4):643-671.
Blumenthal RD, Hansen HJ, Goldenberg DM. Inhibition of adhesion, invasion, and metastasis by antibodies targeting CEACAM6 (NCA-90) and CEACAM5 (Carcinoembryonic Antigen). Cancer Res. 2005;65:8809–8817.
Lee DS, Kim SJ, Kang JH, et al. Serum carcinoembryonic antigen levels and the risk of whole-body metastatic potential in advanced non-small cell lung cancer. J Cancer. 2014;5:663–669.
Arrieta O, Saavedra-Perez D, Kuri R. Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis. BMC Cancer. 2009;9:119.
Noris-Garcia E, Escobar-Pérez X. Brain metastasis and the carcinoembryonic antigen. Rev Neurol. 2004;38:267–270.
Lee DS, Kim YS, Jung SL, et al. The relevance of serum carcinoembryonic antigen as an indicator of brain metastasis detection in advanced non-small cell lung cancer. Tumour Biol. 2012;33:1065–1073.
Ursavaş A, Karadağ M, Ercan I, et al. Serum carcinoembryonic antigen level as a predictive marker for distant metastasis in non-small cell lung cancer. Eur J Gen Med. 2007;4(3):107-114.
The American Thoracic Society and The European Respiratory Society. Pretreatment evaluation of non-small cell lung cancer. Am J Respir Crit Care Med. 1997;156(1):320-322.
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